While the precise human discovery of wine will forever remain a mystery, it is certainly an ancient one. Evidence, such as the recent archeological discovery of ceramic wine storage casks in the present-day country of Georgia, suggests that viniculture dates back at least 8,000 years. Discovery of this “magic juice,” with its mind-altering effects, most certainly had a profound impact on our ancestors. “In a life that was ‘nasty, brutish, and short,’” writes Hugh Johnson in his masterwork The Story of Wine, “those who first felt the effects of alcohol believed they were being given a preview of paradise.” It should therefore come as no surprise that our ancestors were likely quick to learn that the mysterious grape byproduct, wine, could be applied as a remedy to disease and suffering.
As a beverage, Johnson goes on to write, “Wine is the most repeatable of mild narcotics without ill effects—at least in the short or medium term,” but wine had other properties that made it indispensable to our ancestors. “For 2,000 years of medical and surgical history it was the universal and unique antiseptic. . . . Wounds were bathed with it; water made safe to drink.” A number of surprising associations have also placed physicians and the medical science at critical crossroads throughout wine’s history. The story of wine is rife with pioneering winemaking doctors, and physicians over the millennia have made important contributions to wine writing and promotion, as consumers, producers, and prescribers.
The medicinal properties of wine appear to have been widely recognized among ancient civilizations. “The earliest practitioners of medicine,” notes the Oxford Companion to Wine, “were magicians and priests who used wine for healing as well as religious purposes.” Early wine was often flavored with infusions of herbs, spices, and resin, somewhat similar to today’s vermouth. In this sense, it is conceivable that these various flavored tinctures evolved into “medicines” over time.
Wine is our oldest documented medicine: receipts for wine-based medicine have been found written on clay Sumerian tablets (in present-day Iraq) dated between 2200 to 2100 BCE. Likewise, Egyptian papyri dated from around 2000 BCE list various medicinal uses of wine, suggesting that it was utilized as a solvent for mixing other “medicines.” According to the edited volume Wine: A Scientific Exploration, Egyptian prescriptions for wine-based remedies included such diverse indications as “to release a child from the belly of a woman,” “to eradicate asthma,” to “expel epilepsy,” and as a “remedy for dejection.” Wine was also applied to bandages to treat wounds, and externally to promote healing and bring down swelling.
While many of these peculiar applications reflect our ancestors’ primitive biological understanding of disease, as well as the absence of effective treatments, wine did possess therapeutic potential. Its ethanol content and slew of organic acids make it a natural antiseptic. Wine was also recognized for its ability to aid digestion of food, and wine-drinkers appeared better nourished and healthier than others—if nothing else, wine provided supplementary caloric sustenance. The intoxicating effects of wine consumption only seemed to confirm its medicinal properties.
Independent of Mesopotamia, Egypt, and Greece, during the Vedic period of ancient India (1500–800 BCE), wine was recognized for its healing powers. In the sacred Hindu text, the Vedas, wine was worshiped as the liquid god Soma for its medicinal attributes. A sixth-century BCE Indian medical text described wine as the “invigorator of mind and body, antidote to sleeplessness, sorrow and fatigue.” Ancient Sanskrit writings are also among the first to record use of wine as a surgical anesthetic. When Alexander the Great invaded India in 327 BCE, historians believe he returned to Europe with advanced medical knowledge borrowed from Hindu surgeons and physicians, thereby influencing ancient Greek medicine.
Greek physician Hippocrates (470–370 BCE), the father of modern medicine, recognized the antiseptic qualities of wine and recommended it as a wound dressing (“no wound should be moistened with anything except wine”). Hippocrates touted many other medicinal applications of wine, including use as a nourishing dietary supplement, antipyretic (fever-reducing substance), purgative (bowel movement stimulant), and diuretic (substance that promotes urine production). Following Hippocrates, a succession of prominent Greek physicians wrote of the medical uses of wine, including Theophrastus of Eresus (372–287 BCE), Mnesitheus (320–290 BCE), and Athenaeus (170–230 CE), who noted, “In medicine it is most beneficial; it can be mixed with liquid drugs and it brings aid to the wounded.” Wines from the Greek island of Thasos, produced from sun-dried grapes, were highly prized for their aesthetic and medicinal qualities. The latter purportedly included an ability to induce abortions, treat insomnia, and, when mixed with vinegar, heal conditions of the eyes.
Like Hippocrates, Galen, the influential Greek physician from the second century CE, favored wine to prevent infection. Treating injured gladiators in Asia Minor (present-day Turkey), he identified wine’s antiseptic properties, using it to disinfect wounds, lacerations, and amputations. Wine was also utilized to treat gruesome abdominal wounds: exposed internal abdominal contents were soaked in wine before being returned into the body. Later, when Galen became imperial physician to Emperor Marcus Aurelius, his duties progressed to that of sommelier, tasting the emperor’s wine to select the best and most healthful. On this basis, he recommended drier and lighter wines instead of the thick, sweet concoctions that had been popular.
Much of the information known today about the color, quality, and effects of wines from ancient Rome is derived from the notes of doctors. During the expansion of the Roman Empire, Roman soldiers were encouraged to drink wine to prevent dysentery (severe diarrheal disease, usually caused by bacteria-contaminated water), as well as for strength and preservation of health. Asclepiades (124–40 BCE), physician to Cicero and “inventor” of the shower bath for its hygienic value, authored the essay “Concerning the Dosage of Wine,” in which he described the medicinal virtues of various Greek and Roman wines. Another notable Roman physician, Aurelius Cornelius Celsus (25 BCE–50 CE), wrote extensively on wine’s therapeutic virtues, prescribing wines from various regions of Italy, Sicily, and Greece for a range of clinical indications. Pliny the Elder (23/4–79 CE), famous scholar, statesman and physician of ancient Rome, devoted extensive medicinal discussion to wine and grapes in his encyclopedia on plants and medicine, Naturalis Historia. Physicians would continue to recommend wine in the tradition of Greco-Roman medicine until the fall of the Roman Empire.
Ancient Jewish scholars valued wine for its medicinal properties as well. As stated in the Talmud, “Wherever wine is lacking, medicines become necessary.” Later, preeminent Jewish physician and philosopher Maimonides (1135–1204 CE) would advocate for the use of wine as a medicine in his writings.
However, early Arab physicians, who studied medicine from Greek sources and recognized the therapeutic importance of wine, were thrown into a quandary by the teachings of the Koran, which prohibited its consumption. Nonetheless, following the birth of Islam, Arab doctors continued to use wine to prevent infection, applying it to dressings and wounds.
Following the piecemeal dissolution of the Roman Empire, Greek medical texts were slowly reintroduced into Western Europe, in part through Arab translations that emerged in post-Moorish Spain, and at one of medieval Europe’s finest early medical schools, Schola Medica Salernitana, or Salerno, in southern Italy. At Salerno, Arab medical manuscripts were used to compile 11th-century medical recipes; many contained wine. In Regimen Sanitatis Salernitanum, Salerno’s code of health, wine is the most frequently mentioned therapeutic agent, recommended as a nutrient, tonic, antiseptic, and universal solvent for other medicinal substances. With medicinal use of wine as an integral teaching, Salernitan medicine spread throughout Europe.
Influential physician Arnaldus de Villanova (1240–1311 CE), who taught at the University of Montpellier in the south of France (at its time, the most prestigious medical school in southern Europe), wrote the first book on wine ever printed, which reflected his interest in wine’s medicinal properties. Liber de vinis (“Book on Wines”) is heavily influenced by Galen—unsurprising, since Arnaldus translated Galen and a number of medical texts from Arabic to Latin. “If wine is taken in the right measure it suits every age, every time and every region,” wrote Arnaldus, “hence it comes that men experienced in the art of healing have chosen the wine and have written many chapters about it and have declared it to be a useful embodiment or combination of all things for common usage. It truly is most friendly to human nature.” Arnaldus praised wine as a remedy against melancholy (depression) and noted its beneficial effects on the urinary tract, veins, and the liver—somewhat ironically, given that excess alcohol consumption is now recognized as a cause of chronic liver disease. He also advocated for its many uses among the old, including reducing hemorrhoid swelling, being beneficial to digestion, and tempering the rate of gray hair development. Perhaps most importantly, Arnaldus promoted wine as an antiseptic, as, for example, a wound dressing. His teachings on the therapeutic uses of wine influenced European medical practice for centuries. Incredibly, Arnaldus’s writings were still being reprinted in the 16th century.
Henri de Mondeville, a 14th-century French surgeon, advocated for the use of “good wine” in treating disease, and particularly in regenerating blood. Surgeon Hieronymus Brunschwig (1450–1533 CE) treated gunshot wounds with a mixture of strong Gascony wine, brandy, and herbs (agua vite composita). Sixteenth-century Italian physician Baldassare Pisanelli recommended wine in the diets of the elderly as a “supplementary source of warmth to overcome the coldness that accompanies old age.” Over two millennia earlier, Greek philosopher Plato had offered similar advice: while individuals in their twenties should drink wine in moderation, those in their forties could drink as much as they wished “in order to relieve the desiccation of old age.”
In the late 19th century, physicians began to advocate for the medicinal properties of wine with increasingly prescriptive granularity, reflecting improvements in disease classification. Likewise, new categories and styles of wine lent themselves to specialized medical uses, an approach reminiscent of ancient Greek and Roman medical writings. Wine prescriptions now included astringent red wines for diarrhea, white wines as a diuretic, Port for acute fevers and anemia, claret and Burgundy for anorexia, Champagne for nausea and catarrhal conditions (diseases associated with a stuffy or runny nose), and Port, Sherry, and Madeira for convalescence. Dr. Robert Druitt promulgated the distinctive health benefits of French wine in a series of articles published in British medical journals in the 1860s and a best-selling book. He also recommended old Sherry to stimulate the heart, claret as a treatment for gout (a form of arthritis caused by an excess of uric acid) and measles in children, and Champagne for neuralgia (shooting pain as a result of a damaged or irritated nerve) and influenza. Dr. Francis Anstie, a London physician, advised in 1877 that fortified wines were excellent when used as a “dietetic aid in debility of old age,” and recommended light wines with a lower alcohol content for use on a daily basis with lunch and dinner to protect against disease in healthy individuals. Old Sherry treated typhoid fever (a diarrheal disease caused by Salmonella bacteria, usually spread through contaminated food and water), Burgundy was recommended for dyspepsia (symptoms of indigestion), and Port addressed anemia or anorexia. Famed physician Dr. Jean-Martin Charcot, in Traité de Médecine, his 10-volume encyclopedia of current European medicine published between 1899 and 1905, recommended wine-based treatments for a range of conditions. These included pernicious anemia (a condition now known to result from a lack of vitamin B12), aortic aneurysms (an abnormal bulge that occurs in the wall of the body’s largest blood vessel), scurvy (a disease caused by a deficiency of vitamin C), endocarditis (infection of the inner lining of the heart, usually involving the heart valves), and tuberculosis.
The various pharmacopoeias of Europe—official publications, containing lists of medicinal drugs with their effects and directions for their use—provided multiple formulae for medicated wines (vina medicata). The first Pharmacopoeia of the United States (1820) listed nine—all of which would be removed from the 1916 pharmacopoeia as a result of momentum from the Temperance Movement. Wine was also widely used in hospitals; in 1898, a recorded three million liters of wine were served in Paris hospitals alone.
While it is now recognized that virtually all of the historical medical applications ascribed to wine have no basis in science—many of them laughable by modern standards—other treatments of the time were equally bizarre and unfounded (think: mercury-based ointments and bloodletting). Wine, however, was an invaluable antiseptic and a reliably hygienic beverage, free of disease-causing bacteria and parasites. Even after Louis Pasteur discovered in the 1860s that microorganisms could cause disease, wine continued to play an important role in sterilizing contaminated water, being used as late as 1892 during the cholera epidemic in Hamburg, Germany. Accordingly, Pasteur declared wine “the most healthful and most hygienic of beverages.”
The latter half of the 19th century gradually saw a shift in medicinal attitudes toward wine. Alcoholism was recognized as a medical disease, and the deleterious side effects of excessive alcohol consumption began to be acknowledged (coinciding with the temperance movement of the late 19th and early 20th century, particularly influential in the US and UK). But even during the temperance movement, wine was sometimes exempt from restrictions given its medicinal connotations and historical use by physicians (US Prohibition laws allowed medicinal use of alcoholic beverages through prescription). Echoing the teachings of their predecessors, a number of doctors continued to support wine by arguing for appropriate prescription based on the type of wine and disease being treated.
The lasting threat to wine’s status as a widely prescribed medicine was the discovery of effective drugs and treatments that began to appear by the end of the 19th century. Writes Rod Philips in 9000 Years of Wine, “Like powdered herbs, plants, and the other stuff of folk medicine, wine was gradually pushed off the pharmacy shelf as doctors reached for more modern remedies to cure their patients’ ills.”
“Doctors of medicine through the ages have displayed an uncommon affection for wine,” notes the Oxford Companion to Wine, “and not just because of wine’s uses as a medicine and beneficial effects on health.” By any standard, physicians appear to have played an unusually significant role in the history of wine.
A particularly prominent vinous prescription occurred in 17th-century France when Louis XIV’s physician (Guy-Crescent Fagon) prescribed Burgundy over Champagne. In 1694, the Sun King’s doctor insisted that Louis XIV should only drink wines from Burgundy for health reasons. Wines from Champagne—primarily still, light-bodied reds—were “too acidic.” It is purported that the proclamation acted as a catalyst for the Champagne region to reinvent itself, contributing to a shift in the production of sparkling wine. Thus, it can be said, medicine played a significant role in the birth of Champagne.
Physicians pioneered much of the New World’s wine cultivation. The Cape colony’s first European settler, often called the father of the South African wine industry, was a 33-year-old Dutch surgeon named Jan van Riebeeck. He was tasked by the Dutch East India Company with establishing a garden to reduce the risk of scurvy for travelers stopping at the Cape between Europe and the East Indies (now Indonesia). In April 1659, seven years after landing in what is today Cape Town, Riebeeck managed to press Cape wine from grapes: “Today, praise be to God,” he wrote in his journal.
The history of Australian wine has particularly strong medical connections. Dr. William Redfern, appointed by the British government to ensure the safety of convicts transported to the penal colony of Australia, reduced convict mortality using a daily ration of a quarter-pint of wine with added lime juice (countering scurvy and dysentery). Redfern later established a vineyard in the southwest of Sydney in 1818. Dr. Christopher Penfold, who arrived in South Australia in the 1840s, initially planted vine cuttings from southern France to prescribe wine to his patients. “[Dr. Penfold’s] practice came first; wine-growing was an afterthought,” writes Hugh Johnson, “as he discovered how wonderfully his patients cheered up when he prescribed a glass.” Penfolds Grange, named after his homestead, is now one of Australia’s most famous and highest-priced wines. Overall, more than 160 Australian wineries were established by physicians, also including Lindeman's, Hardys (as its forerunner, Tintara), Houghton, Angove, Stanley, and Minchinbury.
Other notable physician winemakers include early Napa Valley pioneer Dr. George Belden Crane, the second biggest grower in the area during the mid-19th century, and Jean-Louis Peste, a doctor at the Hospices de Beaune in Burgundy for 30 years in the mid-19th century. A donation of wine from Dr. Peste’s prized vineyard continues to be sold each year as part of the renowned medical charity auction at Hospices de Beaune.
On the history of wine literature, Hugh Johnson notes, “writing about wine from the consumer’s point of view had been almost a branch of medicine, sometimes practised with great wit and skill even when specific information was lacking.” As noted, Arnaldus de Villanova wrote the first printed book on wine. The first wine book written in English, A New Book of Wines (1568), also came from a doctor, William Turner. Sir Edward Barry, a physician from Bath, England, wrote Observations, Historical, Critical, and Medical, on the Wines of the Ancients; And the Analogy between Them and Modern Wines in 1775. In 1824, Dr. Alexander Henderson (1780–1863), a Scotsman practicing in London, published The History of Ancient and Modern Wines.
If wine retains a niche role in modern medicine, it is primarily a result of the French Paradox, the observation that coronary heart disease mortality is lower in France than would otherwise be expected from the country’s high prevalence of smoking and saturated fat intake. The Irish physician Samuel Black first noted the French Paradox in 1819 in his work Clinical and Pathological: Reports. Describing a distinguished, exhaustive French study on diseases of the heart and large blood vessels, Black noted apparent differences in the prevalence of heart disease observed in Britain and France, ascribing lower rates in France to “French habits and modes of living.” The observation remained largely dormant in medicine until a defining 1979 Lancet publication, “Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine.” As summarized by the authors, “The principal finding is a strong and specific negative association between ischaemic heart-disease deaths and alcohol consumption. This is shown to be wholly attributable to wine consumption.”
The French Paradox hypothesis made a major cultural impact when in 1991, an episode of 60 Minutes was aired featuring French epidemiologist Serge Renaud, coauthor of a 1992 Lancet paper “Wine, alcohol, platelets, and the French paradox for coronary heart disease.” Renaud’s television appearance set off a surge of wine sales in the United States; within a year of the broadcast, red wine purchases had increased by 40%. Renaud’s lasting influence continues today. The Renaud Society, a group of medical professionals with a passion for wine, support wine and health research and education, and promote the sharing of wine interests among medical colleagues worldwide.
Subsequent studies have continued to support an association between a lower overall risk of death and moderate alcohol consumption, seemingly in part due to decreased rates of heart disease and stroke. While the factors responsible for the apparent health benefits of wine consumption remain uncertain, a number of complex mechanisms may be involved. These include alcohol’s effect on raising high-density lipoprotein (HDL) cholesterol, often referred to as “good cholesterol,” and the antioxidant effects of red wine, which may inhibit damaging processes that contribute to the development of atherosclerosis, or the buildup of plaque in the walls of arteries. Further, alcohol demonstrates an ability to improve blood sugar regulation by enhancing the body’s sensitivity to the hormone insulin; dysregulation of insulin is a defining feature of type 2 diabetes, a significant risk factor for development of heart disease. Alcohol also has “antithrombotic effects,” an ability to reduce or mitigate the formation of blood clots, involved in both heart attacks and strokes. Finally, it demonstrates anti-inflammatory impacts, important since inflammation, the body’s response to injury, is believed to play a key role in the development of heart disease. It remains unclear whether wine confers more heart disease protection than other types of alcohol. Most likely, the type of alcohol is not as important as the amount of alcohol consumed and the pattern of intake.
The relative harms and benefits of alcohol, particularly as a function of beverage type, remain hotly debated. And it is not easy to tease out the health benefits of wine consumption from other factors that may contribute to an individual’s decision to abstain from wine or drink in moderation, including underlying health status, income level, and other sociodemographic differences. While the American Heart Association does not recommend consumption of alcohol solely to reduce the risk of heart disease, tacit advice on alcoholic beverage daily limits is provided for those who already drink: no more than two drinks per day for men and one drink per day for women. Swiss medical teacher Theophrastus Bombastus Von Hohenheim (1493–1541) famously stated, “Whether wine is a nourishment, medicine or poison is a matter of dosage.”
According to the World Health Organization’s global status report on alcohol and health, half of all alcohol consumed worldwide is in the form of spirits; beer represents the second most consumed type at 34%, followed by wine at 12%. The leading contributor to the global burden of alcohol-attributable death is not chronic disease as a result of lifelong alcohol use but injury, largely driven by heavy episodic drinking among youth.
“Alcohol can be devastating to health,” writes Hugh Johnson, assessing the several thousand-year contribution wine has made to human civilization, “yet if it had been widely and consistently abused it would not have been tolerated. Wine, unlike spirits, has long been considered the drink of moderation.” Thomas Jefferson, much like early Australian colonists, was convinced that a lack of domestic-made wine drove the public to consume strong drink. He wrote, “No nation is drunken where wine is cheap; and none sober, where the dearness of wine substitutes ardent spirits as the common beverage. It is, in truth, the only antidote to the bane of whiskey.” Jefferson’s determined efforts to plant imported grape vine cuttings from Europe ultimately failed, like those of the many who attempted before him, in part due to the yet-discovered vine-killing aphid phylloxera.
In his 1963 song “I Gotta Get Drunk,” Willie Nelson sings, “There’s a lot of doctors tell me, that I’d better start slowing it down, but there’s more old drunks than there are old doctors, so I guess we’d better have another round.” Such words would not have been unfamiliar to Benjamin Franklin, who quipped in 1736 “There’s more old drunkards, than old doctors.” Nor would this remark surprise the French writer and physician François Rabelais (1494–1553) who wrote almost 200 years before Franklin’s birth: “O, rot your physicians . . . a hundred devils leap into my body, if there be not more old drunkards than old physicians.” Indeed, even aphorisms on wine and medicine are as ancient as they are interwoven.
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Great work, Geoffrey Crawford! Really enjoyed reading.